EVHM LLP - 24 Tower Road West

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

This is the first assessment for this newly registered service. This key question has been rated good. This meant people’s needs were met through good organisation and delivery.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Care plans were written with a very person-centred approach reflecting people’s needs and wishes. Care plans recorded specific health and emotional needs that were individual to each person. For people who experienced distress or anxiety, there were clear, personalised strategies to support their wellbeing and provide reassurance. A staff member told us, “Care plans are clear and if we thought information was missing, we would discuss with management.” Staff also told us that staff meetings were used to make sure everyone was up to date with people’s changing needs so that a consistent approach was maintained.

Daily records were used to describe people’s day, what activities they had done, what they had eaten and general information about their individual wellbeing. People’s relatives told us they were kept informed about changes to people’s needs and involved in decisions about their care and support.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff understood the importance of working closely with professionals when needed to ensure people’s care needs were met. Regular appointments were made with doctors, specialist doctors, chiropody and opticians. Staff understood the needs of autistic people and people with a learning disability and worked to ensure typical barriers faced by people were removed or mitigated against. Staff training ensured that staff had the skills and knowledge to meet people’s needs. Staff had completed online training in mental health and the registered manager advised that they were trying to source more advanced training to enhance staff knowledge in this area. People received support from a consistent staff team for continuity. A number of the staff had worked in the home for a long time and knew people very well.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People’s individual communication needs had been assessed and recorded within communication support plans. Staff were very clear about how people communicated their individual needs. They knew what gave one person more confidence to speak with people that were not known to them. We observed this in practice. Another person did not speak but was clearly able to make their needs known. If staff had difficulty trying to understand the person, they encouraged the person to write what they wanted on paper.

People’s consent was gained to share information about them with other healthcare professionals. All information was stored securely.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People were able to tell us who they would speak with if they were upset or had any worries. The service had introduced monthly keyworker meetings and people had opportunities to share their views and wishes at these meetings. Traditionally people had opted not to have house meetings, but a recent house meeting had been held successfully. The manager told us that staff meet with anyone who didn’t attend to keep them up to date on what was discussed and to hear their individual views.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

Managers and staff were fully aware of people’s health and care needs and recognised the need to support people to access services. They ensured they were not prevented from receiving the care and support they needed due to their health or disability. People had full use of the property. Two people were beginning to find the stairs an issue, and appropriate advice and guidance had been sought to make sure they were safe doing so, and to check if there was support/equipment that could be used to make using the stairs easier for people.

People chose where they wanted to have their meals and with whom, and the building was large enough to accommodate people’s wishes. There was ample outdoor space to also have meals outside if people chose to. People told us occasionally they ate outside but mostly they preferred to eat inside.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

People told us they walked where possible, caught buses, trains and used taxis. Staff told us that people were always clear about where they were going and the purpose of their activity.

Staff were aware of the importance of ensuring people were not subject to inequality or discrimination due to autism, their health needs or any disability. Staff told us that people were well known in their local community. One person went out independently to use local shops. Another was supported to go to monthly singing classes. The person told us they enjoyed singling. Staffing levels enabled people to do activities in the evenings if they chose to. Some chose to go to the pub, attend clubs and a monthly disco, others did not want these activities.

We observed a staff member talking with a person about an activity that might be of interest to them. This was to visit a cat café in a local town. The person showed an interest and the staff member advised that they would arrange for a trip to the café but that this had to be booked so it could not happen straight away. The person understood this.

People were given exceptional support to plan for important life changes, so they could make informed decisions about their future, including at the end of their life.

Nobody required end of life care at the time of this assessment. However, people understood what it was to lose family members and friends and they recognised the importance of saying goodbye to loved ones and working with family members to make sure everyone was involved in the process. During the past year a person at the service and a long serving staff member died. Both had been ill and death was expected. Staff told us very good support was provided to everyone by head office and management. A staff member said, “We supported each other through a very difficult year.” One person had lived with the person who died for 30 years and found it difficult. They requested counselling and staff confirmed this would be provided. The registered manager told us, “It was a privilege to support [Person]. We were able to follow [Person’s] end of life plan. The family came in and did Christmas a week early. When the time came, [Person] held our hands and didn’t let go.” Staff told us that they played the person’s favourite music and at one point they changed the music, but the person was able to indicate that they did not like this and they put their favourite music back on and he instantly relaxed. At the request of the family the registered manager did the eulogy at the funeral service and staff said it was a real, “celebration of life.”

In relation to the staff member who died, a staff member asked if they could have a plaque. The company paid for the plaque to be made, and the staff member arranged this. One person asked if a minister could come and bless it and everyone was invited to the planting of a rose and the laying of a plaque. The person said a prayer, and they had a two-minute silence.

A relative of another person had died recently, and staff had supported the person to attend the funeral. He had written a letter to his loved one at his mum’s suggestion. This had helped him to express his feelings about the relative and his feelings. Staff talked to those that either had or were yet to complete end of life care plans. One person was young and told staff he did not feel he needed a plan yet. Another person refused to discuss the subject. One person who had a plan requested to see his plan to review it. The registered manager compiled an end of life checklist of tasks to be completed following death. The form had been adopted throughout the organisation to help other managers and staff in similar situations.